Steven R Cooperman, Abisola Olaniyan, Roberto A Brandão
{"title":"AI discernment in foot and ankle surgery research: A survey investigation.","authors":"Steven R Cooperman, Abisola Olaniyan, Roberto A Brandão","doi":"10.1016/j.fas.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.fas.2024.10.001","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the ability to differentiate between AI-generated and human-authored abstracts in foot and ankle surgery.</p><p><strong>Methods: </strong>An AI system (ChatGPT 3.0) was trained on 21 published abstracts to create six novel case abstracts. Nine foot and ankle surgeons participated in a blinded survey, tasked with distinguishing AI-generated from human-written abstracts, rating their confidence in their responses. Surveys were completed twice at two different time points to evaluate intra-/inter-observer reliability.</p><p><strong>Results: </strong>The overall accuracy rate for distinguishing AI-generated from human-written abstracts was 50.5 % (n = 109/216), indicating no better performance than random chance. Reviewer experience and AI familiarity did not significantly affect accuracy. Inter-rater reliability was moderate initially but decreased over time, and intra-rater reliability was poor.</p><p><strong>Conclusions: </strong>In their current form, AI-generated abstracts are nearly indistinguishable from human-written ones, posing challenges for consistent identification in foot and ankle surgery.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Federico G Usuelli, Agustin Barbero, Amit Benady, Yair Green Halimi, Nissim Kahimov, Cristian Indino, Camila Maccario, Ben Efrima
{"title":"Reliability analysis of WBCT-derived 3D models for comparing preoperative and postoperative alignment in total ankle arthroplasty.","authors":"Federico G Usuelli, Agustin Barbero, Amit Benady, Yair Green Halimi, Nissim Kahimov, Cristian Indino, Camila Maccario, Ben Efrima","doi":"10.1016/j.fas.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.007","url":null,"abstract":"<p><strong>Background: </strong>Traditional imaging techniques for total ankle arthroplasty (TAA) evaluation are limited by rotational bias and bone superimposition, highlighting the necessity for more precise assessment methods. The advent of weight-bearing computed tomography (WBCT) generated 3D enhance the visualization of foot and ankle alignment, offering unmatched detail. This study aims to assess the accuracy of preoperative and postoperative measurements in TAA across all three planes using WBCT-generated 3D models. We hypothesize that these models can be reliably used to compare preoperative and postoperative alignment.</p><p><strong>Methods: </strong>For 81 patients undergoing TAA, preoperative and postoperative WBCT models were created. Measurements included five coronal angles: Alpha, Tibiotalar Surface Angle (TSA), Talar Tilt Angle (TT), Salzmann's 20 degrees Angle (SA), and Talocalcaneal Angle (TCA); three sagittal angles: Beta, Gamma, and Tibiotalar Ratio (TTR); and one axial angle: The Posterior Talar Rotational Angle (PTARA). Two raters evaluated these before and after surgery in two separate sessions. The study then compared preoperative to postoperative measurements, calculating inter-rater and intra-rater reliability.</p><p><strong>Results: </strong>Significant changes were observed in three coronal angles (TSA, TT, and SA) and two sagittal angles (Beta and Gamma), with P-values of 0.2, 0.007, 0.019, <0.001, and <0.001, respectively. No significant changes were noted in Alpha, TCA, TTR, and PTARA, with P-values of 0.2, 0.9, 0.2, and 0.6, respectively. Intra-rater and inter-rater reliability scores ranged from 0.885 to 0.97, indicating good to excellent interclass correlation across all planes, both pre-and postoperatively.</p><p><strong>Conclusion: </strong>WBCT-generated 3D modeling and image analysis software have enabled a detailed comparison between preoperative alignment and postoperative TAA positioning across coronal, sagittal, and axial planes, revealing significant adjustments in coronal and sagittal alignments. The high reliability and reproducibility of these measurements affirm their value in preoperative planning in improving the accuracy of surgical interventions.</p><p><strong>Level of evidence: </strong>Level III of evidence.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foot and Ankle SurgeryPub Date : 2024-10-01Epub Date: 2024-05-16DOI: 10.1016/j.fas.2024.05.005
Jumpei Inoue, Youichi Yasui, Jun Sasahara, Tetsuya Takenaga, Myongsu Ha, Wataru Miyamoto, Hirotaka Kawano, Hideki Murakami, Masahito Yoshida
{"title":"Comparison of visibility in needle arthroscopy of the ankle according to surgical experience: A cadaveric study.","authors":"Jumpei Inoue, Youichi Yasui, Jun Sasahara, Tetsuya Takenaga, Myongsu Ha, Wataru Miyamoto, Hirotaka Kawano, Hideki Murakami, Masahito Yoshida","doi":"10.1016/j.fas.2024.05.005","DOIUrl":"10.1016/j.fas.2024.05.005","url":null,"abstract":"<p><strong>Background: </strong>Literature regarding the feasibility of inexperienced surgeons using needle arthroscopy is limited. The present study aimed to clarify the feasibility of performing ankle needle arthroscopy for inexperienced surgeons.</p><p><strong>Methods: </strong>Diagnostic needle arthroscopy was performed for 10 cadaveric ankles by two surgeons with different levels of experience in ankle arthroscopy (inexperienced and expert surgeons). The visibility of arthroscopy was assessed based on a 15-point checklist and compared between surgeons. In addition, iatrogenic articular cartilage injury created by the inexperienced surgeon was investigated.</p><p><strong>Results: </strong>The number of visible points was significantly larger for the expert surgeon than for the inexperienced surgeon (14.1 ± 1.0 vs. 13.7 ± 1.0, P = 0.035). The location of cartilage injury was greatest on the medial talar dome when viewing from the anteromedial portal at a rate of 30%.</p><p><strong>Conclusion: </strong>Ankle needle arthroscopy may be an option for surgeons in the future, however, differences in surgeon experience may impact effective visualization.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":"603-607"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence and risk factors of ankle osteoarthritis in a population-based study: Comment.","authors":"Katherine Ning Li","doi":"10.1016/j.fas.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.006","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William J Hlavinka, Tarun R Sontam, Anuj Gupta, Brett J Croen, Mohammed S Abdullah, Casey J Humbyrd
{"title":"Re:Are large language models a useful resource to address common patient concerns on Hallux Valgus? A readability analysis.","authors":"William J Hlavinka, Tarun R Sontam, Anuj Gupta, Brett J Croen, Mohammed S Abdullah, Casey J Humbyrd","doi":"10.1016/j.fas.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.004","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Longitudinal observation of distal tibial degeneration in varus ankle osteoarthritis using plain radiograph.","authors":"Hiroyuki Seki, Tetsuro Kokubo","doi":"10.1016/j.fas.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.005","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the natural history of distal tibial deformity in varus ankle osteoarthritis and to identify risk factors for its progression.</p><p><strong>Methods: </strong>This retrospective longitudinal observational study included 97 ankles with moderate to severe varus ankle osteoarthritis, monitored for > 2 years. Radiographic assessments were conducted on weightbearing plain radiographs at the initial and final visit.</p><p><strong>Results: </strong>Significant tibial anterior surface angle reduction (p = 0.008), talus center medial migration (p = 0.038), and tibial lateral surface angle increase (p = 0.034) occurred. Multiple logistic analysis revealed an association between progression and coronal talar tilt angle at the first visit (odds ratio 1.17, p = 0.015) CONCLUSION: The progression of radiographic distal tibial deformity in varus ankle osteoarthritis was clarified, identifying the coronal talar tilt angle as a risk factor.</p><p><strong>Level of evidence: </strong>Level IV, retrospective longitudinal observation study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Youn-Ho Choi, Si-Wook Lee, Jae Hoon Ahn, Gyu Jin Kim, Mu Hyun Kang, Yoon-Chung Kim
{"title":"Hallux valgus and pes planus: Correlation analysis using deep learning-assisted radiographic angle measurements.","authors":"Youn-Ho Choi, Si-Wook Lee, Jae Hoon Ahn, Gyu Jin Kim, Mu Hyun Kang, Yoon-Chung Kim","doi":"10.1016/j.fas.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.003","url":null,"abstract":"<p><strong>Background: </strong>The relationship between hallux valgus (HV) and pes planus remains unresolved. This study aims to determine the correlation between HV and pes planus using a deep learning (DL) model to measure radiographic angle parameters.</p><p><strong>Methods: </strong>In total, radiographs of 212 feet detectable by the DL model were analyzed. HV was evaluated using the hallux valgus and intermetatarsal angles, while pes planus was assessed using the lateral talo-first metatarsal (Meary's) and calcaneal pitch angles. Correlation analyses were performed for each DL model-measured angle parameter. We investigated whether pes planus worsened with increasing severity of HV and vice versa.</p><p><strong>Results: </strong>All parameters were significantly correlated with each other. Pes planus worsened with increasing severity of HV, and as the severity of pes planus increased, HV also worsened.</p><p><strong>Conclusion: </strong>Utilizing the DL model-assisted radiographic angle measurements, this study established a significant correlation between HV and pes planus.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prediction model for lower limb amputation in hospitalized diabetic foot patients using classification and regression trees.","authors":"Eren Imre, Erdi Imre","doi":"10.1016/j.fas.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.002","url":null,"abstract":"","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T L Lewis,H Mansur,G F Ferreira,M V P Filho,L R Battaglion,R Zambelli,R Ray,G A Nunes
{"title":"Comparative biomechanical study of different screw fixation methods for minimally invasive hallux valgus surgery: A finite element analysis.","authors":"T L Lewis,H Mansur,G F Ferreira,M V P Filho,L R Battaglion,R Zambelli,R Ray,G A Nunes","doi":"10.1016/j.fas.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.001","url":null,"abstract":"BACKGROUNDThere are different screw configurations utilised for minimally invasive hallux valgus (HV) deformity despite limited biomechanical data assessing the stability and strength of each construct. We aimed to compare the strength of various screw configurations for minimally invasive HV surgery using finite element analysis (FEA).METHODSA FEA model was developed from a CT of a female with moderate HV deformity. Five screw configurations utilizing one or two bicortical or intramedullary screws were tested. Stress analysis considered osteotomy displacement, maximum and minimum principal stresses, and von Mises stress for both implants and bone for each screw configuration.RESULTSFixation with two screws (one bicortical and one intramedullary) demonstrated the lowest values for osteotomy displacement, minimum and maximum total stress, and equivalent von Mises stress on the bone and screws in both loading conditions.CONCLUSIONThe optimal configuration when performing minimally invasive surgery for moderate HV is one bicortical and one intramedullary screw.LEVEL OF EVIDENCELevel III.","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"4 3 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142191081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kevin A Wu, Albert T Anastasio, Kishen Mitra, Conor N O'Neill, James A Nunley, Mark E Easley, James K DeOrio, Samuel B Adams
{"title":"Younger age correlates with increased gutter impingement rates after total ankle arthroplasty.","authors":"Kevin A Wu, Albert T Anastasio, Kishen Mitra, Conor N O'Neill, James A Nunley, Mark E Easley, James K DeOrio, Samuel B Adams","doi":"10.1016/j.fas.2024.08.009","DOIUrl":"https://doi.org/10.1016/j.fas.2024.08.009","url":null,"abstract":"<p><strong>Background: </strong>While total ankle arthroplasty (TAA) has evolved over the years with improved designs and enhanced bony fixation methods, it remains a technically demanding procedure with a risk of early postoperative complications. One of the most common complications associated with TAA is medial and lateral gutter ankle impingement, which can lead to issues such as increased pain and decreased range of motion (ROM). However, there is a paucity of information in the literature discussing the impact of certain risk factors on gutter impingement complications.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on a cohort of patients who underwent a TAA at a single institution from 2003 to 2019 with a minimum of 2-year follow-up. Patient were identified as having gutter impingement based on diagnostic imaging and/or clinical examination. Data collection included demographics, implant type, follow-up time, and co-morbidities. Multivariate odds ratios (OR) of experiencing gutter impingement were calculated for perioperative variables.</p><p><strong>Results: </strong>The study included a total of 908 patients who underwent TAA with a minimum of 2 year follow up and 121 patients (13.3 %) who subsequently experienced gutter impingement. The average follow-up time was 5.84 + /- 3.07 years. There were 178 patients under 55 years old, 495 patients aged 55 to 70, and 235 patients over 70 years old. A higher rate of gutter impingement was observed in patients under 55 years of age compared to those aged 55 to 70 and over 70 (20.8 % vs. 13.5 % vs. 7.2 %; p < 0.01). Multivariable logistic regression revealed that patient age was significantly correlated with gutter impingement following TAA, with an OR of 0.94 (CI: 0.91-0.98; p < 0.01).</p><p><strong>Conclusion: </strong>This study demonstrated increased incidence of gutter impingement in younger patients who underwent TAA. Propensity for scar tissue formation may be higher in this population. Scar tissue deposition following TAA can cause narrowing of the medial and lateral clear spaces, potentially leading to gutter impingement. Additionally, younger patients may have increased activity demands, which subsequently may cause higher rates of symptomatic impingement. As increased impingement after TAA may require the need for additional debridement surgeries, it is important to understand the intricate relationship between age and gutter impingement for managing patient expectations following TAA.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}